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  1. Article ; Online: Acute spontaneous non-hemorrhagic adrenal infarction in pregnancy: case-report and literature review.

    Ornaghi, Sara / Fernicola, Federica / Marelli, Elisabetta / Perotti, Mario / Di Gennaro, Filiberto / Cameroni, Irene / Mariani, Eloisa M / Pincelli, Angela I / Colciago, Elisabetta / Cetin, Irene / Vergani, Patrizia

    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

    2023  Volume 39, Issue 1, Page(s) 2234492

    Abstract: Unilateral non-hemorrhagic adrenal infarction (NHAI) is a very uncommon cause of acute abdomen in pregnancy. Diagnosis is highly challenging due to its rarity, heterogeneity of clinical presentation, and inconclusiveness of the initial workup. Timely ... ...

    Abstract Unilateral non-hemorrhagic adrenal infarction (NHAI) is a very uncommon cause of acute abdomen in pregnancy. Diagnosis is highly challenging due to its rarity, heterogeneity of clinical presentation, and inconclusiveness of the initial workup. Timely recognition is pivotal to ensuring optimal outcomes. Here we describe a case of spontaneous unilateral NHAI diagnosed in a singleton pregnant woman at 32 weeks' gestation at our centre and provide the findings of an extensive literature review on the topic. We identified 22 articles describing 31 NHAI cases in 30 obstetric patients: NHAI occurs more frequently on the right side and in the third trimester, and diagnosis is formulated more than 24 h after clinical presentation in 50% of cases; second-level imaging is always necessary to reach a definitive diagnosis and start appropriate treatment. A high degree of clinical suspicion is needed to promptly recognize NHAI in pregnancy, thus allowing appropriate multidisciplinary management and timely treatment initiation. Promotion of knowledge and awareness of NHAI as a potential cause of acute abdomen in pregnancy is mandatory to improve clinical practice and, ultimately, perinatal outcomes.
    MeSH term(s) Pregnancy ; Female ; Humans ; Abdomen, Acute/diagnosis ; Abdomen, Acute/etiology ; Adrenal Gland Diseases/diagnosis ; Pregnancy Trimester, Third ; Infarction/diagnostic imaging ; Infarction/etiology
    Language English
    Publishing date 2023-07-24
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 639237-4
    ISSN 1473-0766 ; 0951-3590
    ISSN (online) 1473-0766
    ISSN 0951-3590
    DOI 10.1080/09513590.2023.2234492
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Will undocumented migrants contribute to change epidemiology, presentation and pharmacologic treatment of diabetes in Western countries?

    Fiorini, Gianfrancesco / Milani, Silvano / Pincelli, Angela I / Calella, Damiano / Galliani, Silvia / Badalamenti, Silvia / Rigamonti, Antonello E / Marazzi, Nicoletta / Sartorio, Alessandro / Cella, Silvano G

    Primary care diabetes

    2019  Volume 14, Issue 1, Page(s) 21–28

    Abstract: Aims: Migrants from countries in which health and social conditions are unsatisfactory, and their offspring, are becoming a growing component of the western population. Available health data show that their morbidity is at least comparable to that of ... ...

    Abstract Aims: Migrants from countries in which health and social conditions are unsatisfactory, and their offspring, are becoming a growing component of the western population. Available health data show that their morbidity is at least comparable to that of the host country population, with a significant contribution of chronic diseases as diabetes. The possibility that diabetes shows different features in undocumented migrants is the hypothesis that we tried to investigate in this study.
    Methods: We retrospectively analysed the data of 413 patients with type 2 diabetes mellitus (T2DM): 222 patients followed in a diabetes clinic at a University Hospital and 191 undocumented migrants cared for by a Charity in Milan, Italy.
    Results: We found that the onset of the disease was earlier in migrants; they showed a significant lower body mass index (BMI) and had lower socioeconomic conditions. They had a worse glycaemic control. The pattern of complications was also different between the two groups, with cardiovascular complications more frequent in Italians. Finally, also pharmacologic treatment differed significantly.
    Conclusions: Age of onset, clinical manifestations and complications of T2DM in undocumented migrants and natives may show significant differences. This is important for both epidemiological and clinical reasons. If these preliminary observations are confirmed by larger studies, we can conclude that undocumented migrants should be screened for T2DM earlier than natives, and that therapies should be tailored to the specific features of their disease.
    MeSH term(s) Adult ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Health Status Disparities ; Healthcare Disparities ; Humans ; Hypoglycemic Agents/therapeutic use ; Italy/epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Social Determinants of Health ; Socioeconomic Factors ; Undocumented Immigrants
    Chemical Substances Hypoglycemic Agents
    Language English
    Publishing date 2019-05-04
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2273997-X
    ISSN 1878-0210 ; 1751-9918
    ISSN (online) 1878-0210
    ISSN 1751-9918
    DOI 10.1016/j.pcd.2019.04.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Solid cell nests of the thyroid gland: morphological, immunohistochemical and genetic features.

    Manzoni, Marco / Roversi, Gaia / Di Bella, Camillo / Pincelli, Angela I / Cimino, Vincenzo / Perotti, Mario / Garancini, Mattia / Pagni, Fabio

    Histopathology

    2015  Volume 68, Issue 6, Page(s) 866–874

    Abstract: Aims: The correct identification of solid cell nests (SCNs) is an important issue in thyroid pathology because of the spectrum of differential diagnoses of this type of lesion.: Methods and results: Ten cases of 295 consecutive thyroidectomies showed ...

    Abstract Aims: The correct identification of solid cell nests (SCNs) is an important issue in thyroid pathology because of the spectrum of differential diagnoses of this type of lesion.
    Methods and results: Ten cases of 295 consecutive thyroidectomies showed the presence of SCNs at histological examination. The identification of the exact SCN type required the distinction of the cystic and solid pattern; SCNs were usually composed of a mixture of main cells (MCs) and C-cells (CCs). The immunohistochemical calcitonin stain identified CCs easily, both inside SCNs and dispersed in islets at the periphery. For the characterization of MCs, we added the utility of p40 to p63. The use of thyroid transcription factor-1 (TTF-1) helped in their identification, as MCs did not react with this marker; the combination of TTF-1 and p40 or p63 IHC stains was useful for the characterization of cystic SCNs of both types 3 and 4. The negativity of mouse monoclonal mesothelioma antibody (HMBE-1) and a very low proliferative index (MIB-1) supported the diagnosis. [Correction added on 23 November 2015, after online publication: MIB-1 was incorrectly defined, the expanded form was deleted.] We discourage the use of galectin-3 (Gal-3) and cytokeratin-19 (CK-19), as they have an important overlap with papillary thyroid carcinoma. The complete absence of any B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutations is an additional fundamental finding.
    Conclusions: We reviewed the most relevant morphological and immunohistochemical features of SCNs and have provided a genetic analysis of the BRAF gene because of its expanding use in thyroid pathology.
    MeSH term(s) Adult ; Aged ; Biomarkers/analysis ; Carcinoma/diagnosis ; Carcinoma, Papillary ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Thyroid Cancer, Papillary ; Thyroid Diseases/diagnosis ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis
    Chemical Substances Biomarkers
    Language English
    Publishing date 2015-10-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.12858
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Effect of a somatostatin infusion on circulating levels of adipokines in obese women

    Rigamonti, Antonello E / Sartorio, Alessandro / Bonomo, Sara M / Giunta, Marialuisa / Grassi, Guido / Perotti, Mario / Cella, Silvano G / Müller, Eugenio E / Pincelli, Angela I

    Metabolism, clinical and experimental. 2012 Dec., v. 61, no. 12

    2012  

    Abstract: OBJECTIVE: Changes in circulating levels of many adipocyte-derived peptides, including adipokines such as adiponectin, leptin and tumor necrosis factor alpha (TNF-α), have been reported in obesity (OB). Somatostatin (SRIF) inhibits circulating levels of ... ...

    Abstract OBJECTIVE: Changes in circulating levels of many adipocyte-derived peptides, including adipokines such as adiponectin, leptin and tumor necrosis factor alpha (TNF-α), have been reported in obesity (OB). Somatostatin (SRIF) inhibits circulating levels of adiponectin and leptin in lean (LN) subjects, but the effect of a SRIF infusion on these adipokines, including TNF-α, in OB is to date unknown. METHODS: Ten young women (5 OB and 5 LN) were studied. All subjects underwent an infusion of SRIF (9 μg/kg/h i.v., over 60 min), with blood samples drawn prior to and at different time intervals after SRIF administration. Plasma levels of adiponectin, leptin and TNF-α were measured at each interval. RESULTS: Basal levels of leptin and TNF-α were significantly higher in OB than LN women, whereas levels of adiponectin were significantly lower in OB than LN subjects. SRIF significantly inhibited plasma concentrations of adiponectin (at 60 min) in both OB and LN women, without affecting those of leptin and TNF-α in either group. In LN subjects, the inhibitory effect of SRIF on plasma adiponectin persisted up to 150 min, whereas SRIF infusion withdrawal in OB women resulted in a prompt restoration of basal levels of the adipokine. CONCLUSIONS: Plasma concentrations of leptin and TNF-α, which are higher in OB than LN subjects, are unaffected by a SRIF infusion, which, in contrast, inhibits circulating levels of adiponectin in both groups, with a delayed return to the baseline secretion of the adipokine in LN subjects.
    Keywords adiponectin ; blood ; leptin ; obesity ; secretion ; somatostatin ; tumor necrosis factor-alpha ; women
    Language English
    Dates of publication 2012-12
    Size p. 1797-1802.
    Publishing place Elsevier Inc.
    Document type Article
    ZDB-ID 80230-x
    ISSN 1532-8600 ; 0026-0495
    ISSN (online) 1532-8600
    ISSN 0026-0495
    DOI 10.1016/j.metabol.2012.05.019
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Effect of a somatostatin infusion on circulating levels of adipokines in obese women.

    Rigamonti, Antonello E / Sartorio, Alessandro / Bonomo, Sara M / Giunta, Marialuisa / Grassi, Guido / Perotti, Mario / Cella, Silvano G / Müller, Eugenio E / Pincelli, Angela I

    Metabolism: clinical and experimental

    2012  Volume 61, Issue 12, Page(s) 1797–1802

    Abstract: Objective: Changes in circulating levels of many adipocyte-derived peptides, including adipokines such as adiponectin, leptin and tumor necrosis factor alpha (TNF-α), have been reported in obesity (OB). Somatostatin (SRIF) inhibits circulating levels of ...

    Abstract Objective: Changes in circulating levels of many adipocyte-derived peptides, including adipokines such as adiponectin, leptin and tumor necrosis factor alpha (TNF-α), have been reported in obesity (OB). Somatostatin (SRIF) inhibits circulating levels of adiponectin and leptin in lean (LN) subjects, but the effect of a SRIF infusion on these adipokines, including TNF-α, in OB is to date unknown.
    Methods: Ten young women (5 OB and 5 LN) were studied. All subjects underwent an infusion of SRIF (9 μg/kg/h i.v., over 60 min), with blood samples drawn prior to and at different time intervals after SRIF administration. Plasma levels of adiponectin, leptin and TNF-α were measured at each interval.
    Results: Basal levels of leptin and TNF-α were significantly higher in OB than LN women, whereas levels of adiponectin were significantly lower in OB than LN subjects. SRIF significantly inhibited plasma concentrations of adiponectin (at 60 min) in both OB and LN women, without affecting those of leptin and TNF-α in either group. In LN subjects, the inhibitory effect of SRIF on plasma adiponectin persisted up to 150 min, whereas SRIF infusion withdrawal in OB women resulted in a prompt restoration of basal levels of the adipokine.
    Conclusions: Plasma concentrations of leptin and TNF-α, which are higher in OB than LN subjects, are unaffected by a SRIF infusion, which, in contrast, inhibits circulating levels of adiponectin in both groups, with a delayed return to the baseline secretion of the adipokine in LN subjects.
    MeSH term(s) Adipokines/blood ; Adult ; Blood Glucose/metabolism ; Body Mass Index ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infusions, Intravenous ; Insulin/blood ; Leptin/blood ; Obesity/blood ; Obesity/metabolism ; Somatostatin/administration & dosage ; Somatostatin/analogs & derivatives ; Somatostatin/metabolism ; Thinness/blood ; Tumor Necrosis Factor-alpha/blood
    Chemical Substances Adipokines ; Blood Glucose ; Insulin ; Leptin ; Tumor Necrosis Factor-alpha ; Somatostatin (51110-01-1)
    Language English
    Publishing date 2012-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80230-x
    ISSN 1532-8600 ; 0026-0495
    ISSN (online) 1532-8600
    ISSN 0026-0495
    DOI 10.1016/j.metabol.2012.05.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effect of somatostatin infusion on peptide YY secretion: studies in the acute and recovery phase of anorexia nervosa and in obesity.

    Rigamonti, Antonello E / Cella, Silvano G / Bonomo, Sara M / Mancia, Giuseppe / Grassi, Guido / Perotti, Mario / Agosti, Fiorenza / Sartorio, Alessandro / Müller, Eugenio E / Pincelli, Angela I

    European journal of endocrinology

    2011  Volume 165, Issue 3, Page(s) 421–427

    Abstract: Objective: Changes in many gastrointestinal peptides, including the anorexigenic peptide YY (PYY), which is produced by L cells, occur in both anorexia nervosa (AN) and obesity (OB). High PYY levels are present in AN, whereas in morbid OB fasting and ... ...

    Abstract Objective: Changes in many gastrointestinal peptides, including the anorexigenic peptide YY (PYY), which is produced by L cells, occur in both anorexia nervosa (AN) and obesity (OB). High PYY levels are present in AN, whereas in morbid OB fasting and postprandial PYY secretion is blunted. Somatostatin (somatotropin release-inhibiting factor (SRIF)) reportedly inhibits plasma PYY concentrations in animals and healthy humans, but the effect of a SRIF infusion on spontaneous PYY secretion in AN and OB is unknown.
    Methods: A total of 18 young women, seven with acute AN (A-AN), four with AN in the recovery phase (R-AN), and seven with morbid OB, were studied. All subjects underwent an infusion of SRIF (9 μg/kg i.v./h, over 60 min), with blood samples drawn before and at different time intervals after SRIF administration. Plasma PYY levels were measured at each time point.
    Results: SRIF significantly inhibited plasma PYY concentrations in R-AN and OB, without affecting PYY titers in A-AN. In OB, the inhibitory effect of SRIF also persisted at 90 min. Withdrawal of SRIF infusion in R-AN resulted in a prompt restoration of basal plasma PYY levels, whereas termination of SRIF infusion in OB was followed by a slower increase of PYY titers toward baseline levels. After infusion, PYY Δ area under the curve (ΔAUC) in R-AN was significantly higher than those in A-AN and OB patients. A significant difference in PYY ΔAUC between A-AN and OB was present.
    Conclusions: These results suggest the existence of a hypo- and hyper-sensitivity of L cells to the inhibitory effect of SRIF in A-AN and OB respectively.
    MeSH term(s) Adolescent ; Adult ; Anorexia Nervosa/physiopathology ; Body Mass Index ; Female ; Humans ; Obesity, Morbid/physiopathology ; Peptide YY/blood ; Peptide YY/secretion ; Postprandial Period ; Somatostatin
    Chemical Substances Peptide YY (106388-42-5) ; Somatostatin (51110-01-1)
    Language English
    Publishing date 2011-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1183856-5
    ISSN 1479-683X ; 0804-4643
    ISSN (online) 1479-683X
    ISSN 0804-4643
    DOI 10.1530/EJE-11-0312
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Somatostatin infusion withdrawal: studies in the acute and recovery phase of anorexia nervosa, and in obesity.

    Pincelli, Angela I / Rigamonti, Antonello E / Scacchi, Massimo / Cella, Silvano G / Cappa, Marco / Cavagnini, Francesco / Müller, Eugenio E

    European journal of endocrinology

    2003  Volume 148, Issue 2, Page(s) 237–243

    Abstract: Objective: Changes in GH/IGF-I axis activity occur in both anorexia nervosa (AN) and obesity (OB). A GH hypersecretory state with very low plasma IGF-I levels is present in AN, whereas in morbid OB, GH secretion is dull and plasma IGF-I levels are ... ...

    Abstract Objective: Changes in GH/IGF-I axis activity occur in both anorexia nervosa (AN) and obesity (OB). A GH hypersecretory state with very low plasma IGF-I levels is present in AN, whereas in morbid OB, GH secretion is dull and plasma IGF-I levels are generally preserved. Endogenous GHRH activity in AN and OB has never been directly studied, although indirect evidence would indicate that GHRH function is altered in either condition, possibly enhanced and reduced respectively. Somatostatin (SS) infusion withdrawal (SSIW) is followed by a rebound rise of plasma GH in animals and humans, an event which, allegedly, is mediated by endogenous GHRH release.
    Methods: In the present study, 28 young women, eight with active AN (A-AN), six with AN in the recovery phase (R-AN), eight with morbid OB, and six healthy age-matched normal weight subjects (NW), were studied. All subjects underwent, on different occasions, the following two tests: (i) acute GHRH injection (1 microg/kg, i.v.); (ii) infusion of SS (9 microg/kg per h i.v. over 60 min), with blood samples drawn prior to and at different intervals after drug injections. Plasma GH levels were measured at each time interval in all sessions, and, in addition, baseline plasma estradiol, free triiodothyronine, TSH, IGF-I and insulin were measured at -30 min.
    Results: Baseline plasma GH concentrations were significantly higher in A-AN than in NW (4.7+/-0.7 vs 2.1+/-0.6 microg/l, P<0.01). Baseline GH levels in R-AN were also higher than in NW, but the difference did not reach statistical significance (5.6+/-1.7 microg/l, not significant (NS)). Baseline plasma GH concentrations were significantly lower in OB than in NW (0.3+/-0.1 microg/l, P<0.01). GHRH-stimulated GH release was significantly higher in A-AN than in NW (mean change in area under the curve (DeltaAUC) 1904.9+/-626.1 vs 613.9+/-75.9 microg/l per min, P<0.01), whereas no statistically significant difference was present between R-AN and NW (mean DeltaAUC 638.2+/-293.0 microg/l per min, NS); in OB, GHRH failed to evoke a plasma GH rise (mean DeltaAUC 239.8+/-89.9 microg/l per min vs A-AN, R-AN, and NW, P<0.01). SS infusion markedly reduced plasma GH concentrations in both A-AN and R-AN and, to a lesser extent, in NW, but failed to do so in OB. In A-AN, SSIW was followed by a plasma GH rise markedly higher than that present in NW (mean DeltaAUC 193.0+/-42.3 vs 60.1+/-11.4 microg/l per min, P<0.01), whereas in R-AN the GH response after SSIW was nearly superimposable on that registered in NW (mean DeltaAUC 72.9+/-22.8 microg/l per min, NS). There were no changes in plasma GH levels after SSIW in OB (mean DeltaAUC 22.8+/-9.7 microg/l per min). In all groups, DeltaAUCs of the GH response to GHRH and after SSIW were highly positively correlated (r=0.7, P<0.01).
    Conclusions: These data support the view that a high endogenous GHRH tone, which subsides in the recovery phase of the disease, is present in AN, whereas GHRH hypofunction, possibly associated with pituitary impairment, might indicate OB.
    MeSH term(s) Adolescent ; Adult ; Anorexia Nervosa/physiopathology ; Drug Administration Schedule ; Female ; Growth Hormone/blood ; Growth Hormone-Releasing Hormone/pharmacology ; Humans ; Infusions, Intravenous ; Obesity, Morbid/physiopathology ; Osmolar Concentration ; Reference Values ; Somatostatin/administration & dosage
    Chemical Substances Somatostatin (51110-01-1) ; Growth Hormone (9002-72-6) ; Growth Hormone-Releasing Hormone (9034-39-3)
    Language English
    Publishing date 2003-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1183856-5
    ISSN 1479-683X ; 0804-4643
    ISSN (online) 1479-683X
    ISSN 0804-4643
    DOI 10.1530/eje.0.1480237
    Database MEDical Literature Analysis and Retrieval System OnLINE

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